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Metabolomics of Children and Adolescents Exposed to Industrial Carcinogenic Pollutants
http://utaipeir.lib.utaipei.edu.tw/dspace/handle/987654321/18483
title: Metabolomics of Children and Adolescents Exposed to Industrial Carcinogenic Pollutants abstract: Studies on metabolomes of carcinogenic pollutants among children and adolescents are limited. We aim to identify metabolic perturbations in 107 children and adolescents (aged 9–15) exposed to multiple carcinogens in a polluted area surrounding the largest petrochemical complex in Taiwan. We measured urinary concentrations of eight carcinogen exposure biomarkers (heavy metals and polycyclic aromatic hydrocarbons (PAHs) represented by 1-hydroxypyrene), and urinary oxidative stress biomarkers and serum acylcarnitines as biomarkers of early health effects. Serum metabolomics was analyzed using a liquid chromatography mass spectrometry-based method. Pathway analysis and “meet-in-the-middle” approach were applied to identify potential metabolites and biological mechanisms linking carcinogens exposure with early health effects. We found 10 potential metabolites possibly linking increased exposure to IARC group 1 carcinogens (As, Cd, Cr, Ni) and group 2 carcinogens (V, Hg, PAHs) with elevated oxidative stress and deregulated serum acylcarnitines, including inosine monophosphate and adenosine monophosphate (purine metabolism), malic acid and oxoglutaric acid (citrate cycle), carnitine (fatty acid metabolism), and pyroglutamic acid (glutathione metabolism). Purine metabolism was identified as the possible mechanism affected by children and adolescents’ exposure to carcinogens. These findings contribute to understanding the health effects of childhood and adolescence exposure to multiple industrial carcinogens during critical periods of development.
<br>生命早期經驗與非傳染性疾病防治:歷史備忘錄
http://utaipeir.lib.utaipei.edu.tw/dspace/handle/987654321/18482
title: 生命早期經驗與非傳染性疾病防治:歷史備忘錄How do Volunteer's Experiences of Organizational Facilitators Influence Their Satisfaction and Loyalty: An Example of Hospital Volunteers
http://utaipeir.lib.utaipei.edu.tw/dspace/handle/987654321/18481
title: How do Volunteer's Experiences of Organizational Facilitators Influence Their Satisfaction and Loyalty: An Example of Hospital Volunteers abstract: The volunteer experience in organizational context has received far less scrutiny. Studies have indicated specific organizational settings, such as schedule flexibility, orientation and training, empowerment, social interaction, reflection, and rewards, and each has certain influences on their satisfaction and intention of remain. But we do not know their combined impact as organizational facilitators. This study focused on a sample of hospital volunteering, which occupies the largest service hours of volunteering work in Taiwan. We explored the experience of organizational facilitators that affect the satisfaction and loyalty of the volunteers from 868 valid questionnaires in a metropolitan hospital. The results showed that volunteers with more experiences on social interaction, reflections, and rewards, were more satisfied. In term of loyalty, volunteers with higher satisfaction showed higher willing to remain, recommend, accept services, and donate. Furthermore, because of flexible schedules and preferable rewards, the volunteers were more willing to remain; because of more training, higher social interaction, reflections, and rewards, the volunteers were more willing to recommend volunteering and accept services. Additionally, less flexible schedules, better empowerment, and more reflections as well as rewards influenced volunteers to be more motivated to donate. Implications of organizational efforts toward the hospital volunteer management are discussed.
<br>從國際經驗省思全民健保地區預算之分配方法
http://utaipeir.lib.utaipei.edu.tw/dspace/handle/987654321/18480
title: 從國際經驗省思全民健保地區預算之分配方法 abstract: 全民健保自1998年陸續實施牙醫門診、中醫、西醫基層、醫院等部門之總額支付制度,在此制度下將預算分配到健保署各業務分組,以促進各地區醫療資源之有效自主管理。然而目前各總額部門之地區預算分配方式互異,雖遭致許多批評但應如何修訂迄今仍難凝聚各方共識。部分醫界代表及專家學者認為,除了現行地區預算分配方式中納入的分配參數,也應將各地區醫療需求程度差異、人口風險因子、醫療服務提供者之執業成本、醫療服務供給等因素納入考量。因此本研究經由文獻探討,瞭解實施總額支付制度或醫療先進之國家,其地區醫療預算分配方式、參考因素、發展趨勢與經驗,以提出臺灣全民健保總額支付制度下地區預算分配方式之改善方向及具體建議,提供主管機關作為未來政策修訂之參考。本研究經由文獻探討發現,英國、澳洲、紐西蘭等國有進行地區醫療預算之分配,且均採用「以人口為基礎」(population-based)、或稱為「以需求為基礎」(need-based)之預算分配方法。分配預算的參考因素或校正因子除了基本的年齡、性別組成,多數國家也納入民眾罹病狀態、社經特性以反映不同地區民眾對醫療需求的差異;有些國家亦將供給面的成本差異或未被滿足的醫療需求等因素納入分配預算的條件。各國預算分配機制除了反映醫療需求的差異,也期望透過地區預算的分配降低地區間的醫療資源分配不公平。本研究建議於未來的地區預算分配機制中,納入罹病狀態與社經特性等參考因子,並建議發展本土化、共通性的社經特性測量工具,並進行調查研究以瞭解現況下民眾有多少未被滿足的醫療需求。
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